REPORT 6: CONFIDENTIALITY IN DENTAL PRACTICE
Medical practitioners understand the importance of confidentiality with respect to patient treatment and various protocols pertaining to it. Many patients rightly feel that they hold the right to retain their own health information. Some may even retain this kind of information from their health practitioner. But in order to provide the best of health services with least complications, it is the health care provider’s duty to ensure all health related information has been collected and properly recorded.
Patients hold the right to have their personal and medical information kept private. The Data Protection Act and Patient Rights etc. have been designed to protect the information provided by the patient and prevent it from being misused. Such steps if not followed can lead to accountability of the provider giving the services, and therefore, this matter should not be taken lightly. It is the practitioner’s responsibility to maintain, store and keep the records secretive and provide the patient confidence that every effort has been made in this regard.
Therefore, when gathering information, I ensure that the patient and I communicate in solitude in the dental office. I emphasize the importance of correct and detailed information regarding health, no matter how trivial it may seem to the patient, and then proceed on to record the medical history. Before starting, I ensure the patient that every detail given to me will be kept in confidentiality and will not be accessible to every person. In this regard, I keep the records in my own office, where other members of the staff are not allowed. Regarding the information that is entered in the computer, I ensure that my computer is password protected and that only I have the access to read and study the documents.
The patients need to be assured that their information they are providing is in safe hands. Therefore, among other things, I ask the patients to be truthful in their accounts. This is because many patients may not want to disclose certain illnesses; among them the most common being sexually transmitted diseases, blood borne diseases and mental or psychiatric ailments. I tell them that an illness is an illness, regardless of the mode of acquisition or its type and each has a specific impact on the dental procedures. In this regard, I emphasize the many drugs and medications that are given for other illnesses may not “go well” with the medications or procedures during dental treatment and in order to avoid problems, the details must be known.
Certain information such as payment plan etc. is also very important and personal information. Patients may not want to disclose that they are on social care, especially in front of staff or other patients. In this regard, I ask the patients during the first visit of their payment plan, and if such a mode of payment exists where the patient needs confidentiality, I ensure that I carry out the billings and other procedures by myself and not hand it over to my staff. Sometimes in this regard, I need to contact the various authorities and companies responsible for the payment for patient. In such cases, I make sure that all communication I carry out is in the privacy of my office, with no other person in the presence. This also prevents information from spreading to unconcerned people.
At other times, where the patient has disclosed that he or she carries hepatitis virus, or HIV or any other such disease, I make sure that such cases and its files are kept very carefully. Any communication that I do with them in person is in full privacy. And any information that needs to be discussed on the phone, I do so in my own office with no interference. I also make sure when talking to the patient that I do not state the exact illness, but say words and phrases such as “regarding your issue”, ‘regarding your problem” etc. I try to convey the information on the reports in a general tone. For example, if I need to say that your HIV blood test turned out to be positive, I simply state that its better we meet in person to discuss your results, or that your test came out positive without stating what test was conducted.
Similarly, another important source of communication in the era of technology is the use of email and fax system. While these methods may be used publicly to remind the patients of their appointments, it is not a very safe option to use regarding personal health issues. I therefore, in my initial interviews, ask the patients whether the contact information I am being provided is private or public, and insist that in order to protect the privacy, such methods should best be avoided. If these forms of communication are unavoidable and I need to relay some important confidential information, I usually state that I need to discuss your case further and would appreciate it if we do so in private. I explain to the patients before hand that should I write such a statement, it means that there is some important issue that needs to be discussed in private, so that the patient does not disregard it.
Finally, I ask the patients regarding their preference over sharing their information with close relatives. Many patients are fine with the idea of their spouses, children or siblings knowing about their condition or issues. However, some may wish to keep this information private. In this regard, I make sure to enter in the details exactly whom I can share the information. I also make sure to state firmly to those who are not supposed to know such information of the desire of the patient. In this manner, my priority remains to keep the patient’s secret safe, and thereby gain his or her confidence.